Provider Demographics
NPI:1952013906
Name:COURT, JANETTE AMBRIZ
Entity type:Individual
Prefix:
First Name:JANETTE
Middle Name:AMBRIZ
Last Name:COURT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1887 BUSINESS CENTER DR STE 3A
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-3445
Mailing Address - Country:US
Mailing Address - Phone:909-381-3002
Mailing Address - Fax:
Practice Address - Street 1:1887 BUSINESS CENTER DR STE 3A
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-3445
Practice Address - Country:US
Practice Address - Phone:909-381-3002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-21
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker